Multiple Sclerosis Centers of Excellence
Multiple Sclerosis Surveillance Registry
The purpose of the MS Surveillance Registry (MSSR) is to understand the unique characteristics and treatment patterns of Veterans with multiple sclerosis (MS) in order to optimize their care in the VA system. Clinicians input MS-specific clinical data into the MSSR either through the MS Assessment Tool (MSAT) linked to CPRS or directly from the MSSR website. Other data is automatically fed into the MSSR from existing databases. The MSSR allows MS clinics to view summary data charts of all their Veterans with MS, as well as summarize MS histories for individual patients. Please see Figure 1 below for a better understanding regarding the flow of information.
History and Organization of the MSSR
The first step towards a national MS registry was the creation of a prototype data entry template and web-based clinician dashboard in 2013, through a collaborative effort between the VA Multiple Sclerosis Centers of Excellence (MSCoE) and VA Northwest Innovation Center at the VA HCS in Portland, OR. This prototype served as the basis for a grant application to the VA Office of Information Technology (VA OI&T) for a national registry in 2013. Our team, led by Drs. Mitch Wallin and Joel Culpepper, was awarded a VA OI&T contract package in 2013 for national development and sustainment of the MSSR.
Along with a federal IT contractor, the MSCoE team developed the MSSR within the VA Converged Registries Solution (CRS). The CRS platform is a hardware and software architecture designed to host VA clinical registries and eliminate duplicative development effort while maximizing the ability to create new patient registries. The common platform includes a relational database, HL7 messaging, software classes, security modules, extraction services, and other components. The CRS routes data from the VA Corporate Data Warehouse (CDW), directly from the Veterans Health Information Systems and Technology Architecture (VistA), as well as by direct user input, into the MSSR. The server for CDW was updated in 2019 to the Veteran Integrated Registry Platform (VIRP).
In 2014-2015, the MSSR was piloted in Veterans Integrated Service Networks (VISN) 5 and 20 and modifications were made to the web-based input tool and data captured through the CDW. The web input tool, called the MS Assessment Tool (MSAT), was finalized and integrated with CPRS to allow for secure entry of demographic and clinical data into the MSSR in 2015. During this period, a method to roll out the MSSR and MSAT to VA Regional Programs was developed. In addition, the ability to edit data that was input to the MSSR was added to the system.
Due to challenges of linking the MSAT through CPRS at each individual VAMC and the eventual replacement of CPRS by the Cerner electronic medical record, the MSSR contract team developed a mechanism for direct entry of patients to the registry without the MSAT. This method was piloted at VAMCs in Washington, DC and Portland, OR and released into production in 2019. Once an individual provider is registered in the web site portal, they can enter or edit patients in the MSSR. The URL to access the MSSR is: https://vaww.virp.registries.aac.va.gov/.
Figure 1. MSSR Data Flow and System Design. Tele-visits can take place via clinical-video connection or via telephone.
For MSSR access and sign-on questions, please contact the individuals below.